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pathology > Meeran’s Mock > Flashcards

Meeran’s Mock Flashcards

1
Q

post thyroidectomy has tingling
which electrolyte to measure?

A

CALCIUM

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2
Q

why does postthyroidectomy pt have tingling ?

A

iatrogenic removal of parathyroid too, resulting in low Calcium

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3
Q

what marker is raised in Pagets

A

ALP

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4
Q

why does pagets have a raised ALP

A

increased osteoclast and blast activity

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5
Q

Ix of Pagets

A

technetium 99 bisphosphonate bone scan

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6
Q

what does technetium 99 bisphosphonate bone scan show

A

uptake by bones with high osteoblast activity

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7
Q

what would a plain XR show in pagets

A

fractures

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8
Q

what type of hearing damage does Pagets cause

A

conductive and sensorineural

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9
Q

why does Pagets cause conductive and sensorineural hearing loss

A

conductive - ossicles damage
sensorineural - presses on CN8

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10
Q

what marker is raised in osteomalacia

A

ALP

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11
Q

why is ALP raised in osteomalacia

A

increased bone turnover
high ALP
slightly low Calcium

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12
Q

what causes osteomalacia

A

low vitamin D (secondary hyperparathyroidism)

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13
Q

what markers are raised after an MI

A

AST
troponins
CK
LDH

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14
Q

why is AST increased after an MI

A

AST is found outside the liver too, including in the heart

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15
Q

electrolytes in Addisons

A

high K
low Na

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16
Q

what marker is raised in jaundice caused by gallstones

A

ALP

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17
Q

what is the portal triad

A

bile duct
portal vein
hepatic artery

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18
Q

is the blood in central vein ‘clean’ or ‘dirty’ and why

A

clean - its been through the hepatocytes before entering central vein

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19
Q

what marker is raised in obstructive jaundice & why

A

ALP - found near portal triad

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20
Q

what marker is raised in alcoholism and why

A

AST - found near central vein

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21
Q

what marker is raised in jaundice caused by viral hepatitis

A

ALT&raquo_space; AST

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22
Q

why does ALT rise after viral hepatitis

A

inflamed hepatocytes

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23
Q

what marker is raised in jaundice caused by chronic alcoholic cirrhosis

A

AST

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24
Q

why is AST released the most after alcoholic cirrhosis

A

liver architecture is destroyed by mast cell death –> nodules produced –> release AST

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25
Q

what marker is raised in prostatic carcinoma (another name for PSA)

A

acid phosphatase

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26
Q

Calcium, vitamin D and ALP levels in primary hyperparathyroidism

A

high Ca
low vitamin D - gets consumed quickly
high ALP

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27
Q

what marker is raised in dehydration causing AKI

A

urea

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28
Q

if GFR falls in CKD, what will happen to the creatinine

A

increase

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29
Q

what is the marker of GFR

A

creatinine

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30
Q

how does the reactivity of urea differ in CKD vs normal person

A

less reactive in CKD

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31
Q

what is the marker of glucose control over the last 3 months

A

HbA1c

32
Q

what is the marker of glucose control over the last 3 weeks

A

fructosamine

33
Q

what is fructosamine used for and why

A

protein with shorter half life than RBC, so better for frequent glucose monitoring

34
Q

30M polyuria nad polydipsia. High Ca, normal PTH, low PO43-. Dx?

A

primary hyperparathyroidism

35
Q

what is primary hyperparathyroidism

A

inappropriately normal PTH in the presence of high calcium

36
Q

50F Asian woman with tingling. carpal spasm on BP check. low Ca, very high PTH. Dx?

A

secondary hyperparathyroidism

37
Q

what is secondary hyperparathyroidism caused by

A

chronic low vit D

38
Q

what is secondary hyperparathyroidism aka

A

osteomalacia

39
Q

50F asian woman with nocturne and dizziness. low blood glucose, high calcium, normal PTH, low Na and high K. Dx?

A

Addisons

40
Q

60M knee pain. aspiration of joint = positively birefringent crystals. Dx?

A

pseudo gout

41
Q

what is lesch-nyan syndrome

A

uric acid metabolism issue, causing you to get gout

42
Q

30M polyuria and polydipsia. High Na, everything else normal. Dx?

A

Diabetes insipidus (vasopressin deficiency)

43
Q

30M jaundice, conjunctival haemorrhages. Been canoeing in the US. Dx?

A

Leptospirosis

44
Q

what is a rodent ulcer aka

A

basal cell carcinoma

45
Q

what organ is this from

A

thyroid
- thyroglobulin surrounded by follicular cells

46
Q

what organ is this from

A

liver
- portal triad and central vein with dense hepatocytes in-between

47
Q

what organ is this from

A

kidney
- glomeruli (big round things) with tubules near

48
Q

what organ is this from

A

adrenal
- dense, smooth edge is zona glomerulosa. paler central area is medulla.

49
Q

high urinary sodium osmolality, low blood sodium osmolality. Dx?

A

SIADH

50
Q

what causes the high urinary and low blood sodium zinc in SIADH

A

reabsorbing lots of water therefore urine very concentrated and blood very dilute

51
Q

if the blood osmolality is low, what should the urine osmolality be?

A

VERY low - pee out all the dilute urine to get rid of water

52
Q

25F hits head then gets very thirsty with nocturia. Low blood sodium osmolality. Dx?

A

psychogenic polydipsia

53
Q

25F hits head then gets very thirsty with nocturia. Low blood sodium osmolality. why can’t this be DI?

A

DI is deficiency of vasopressin, causing no water to be reabsorbed therefore Na would be really HIGH

54
Q

40M HTN. Low K, high renin, high aldosterone. Dx?

A

renal artery stenosis

55
Q

40M HTN. Low K, high renin, high aldosterone. why is this renal artery stenosis?

A

high renin ! also highaldosterone

56
Q

causes of renal artery stenosis in kids vs elders

A

kids = fibromuscular
elderly = cholesterol

57
Q

40M HTN. Low K, low renin, high aldosterone. Dx?

A

Conn’s syndrome

58
Q

40M HTN. Low K, low renin, high aldosterone. why is this conns?

A

suppressed renin !

59
Q

tired pt has low Na, high K, low glucose. Dx?

A

Addisons

60
Q

ACEi in DM pts - what is their effect on creatinine?

A

worsens creatinine within days of starting

61
Q

ACEi in DM pts - what is their benefit?

A

prevents end stage renal failure

62
Q

what causes increased creatinine with ACEi in DM pts

A

ACEi reduce A2 and aldosterone, but also reduced glomerular pressure. this reduces albuminuria, which increases creatinine

63
Q

what other drug class has a similar effect on the kidneys as ACEi in DM pts

A

SGLT2i

64
Q

when should ACEi be stopped in DM pts temporarily and why

A

sepsis and pneumonia
need the GFR back

65
Q

what kidney condition is an absolute CI to ACEi and why

A

renal artery stenosis
- causes GFR to fall to 0 and pt will die

66
Q

Tx of choice for albuminuria in DM pt

A

ACEi

67
Q

what needs to be checked a few days after starting ACEi in DM pts and why

A

GFR - to check if there was any underlying renal artery stenosis that could cause GFR to fall to 0 and kill pt

68
Q

deadly strain of malaria causing organ damage due to impaired microcirculation

A

plasmodium falciparum

69
Q

malaria strain that need primaquine 30mg to eradicate liver paras

A

plasmodium vivax

70
Q

test to determine species of malaria parasite

A

THIN film

71
Q

what is the thick film test for malaria actually for

A

to detect any malaria there at all

72
Q

45F itchy skin, raised ALP and AMA+. Dx?

A

PBC

73
Q

15M liver disease and Kayser Fleischer rings. Dx?

A

Wilsons

74
Q

pt visited India, now has fever, jaundice and malaise. Raised ALT. Dx?

A

Hep A

75
Q

45M. High BR, high PTT, low albumin, folate and B12. Leucocytosis. Dx?

A

alcoholic liver disease
- albumin is low therefore chronic

76
Q

45F with UC has jaundice etc. ERCP = beaded appearance. Raised ALP and BR. Hypergammaglobulinaemia. Dx?

A

PSC

pathology (87 decks)

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